Scrambler Therapy for Neuropathic Pain
Scrambler Therapy for Neuropathic PainP
eripheral neuropathy affects over 20 million people in the United States. Nearly 60% of diabetics suffer from peripheral neuropathy. It is common, but what is it?
eripheral neuropathy is a general term referring to a group of conditions that cause nerve pain. “Peripheral” points out the fact that the condition affects the arms and/or legs. “Neuropathy” means an abnormal condition of the nerves. In this case, the abnormal condition is pain from the nerves. We all know that the nerves are essentially the highways that pain signals travel on. If we twist our ankle, it is the peripheral nerves that carry the “pain information” from our ankle to our brain. However, in the case of peripheral neuropathy it is the nerves themselves that become the source of the pain.
How does this happen? There are a number of reasons nerves become damaged or injured. Direct trauma to a nerve through an injury is one source. Examples are when a nerve is damaged by a bone fracture, a herniated disc in the low back, or from pinching by scar tissue after a surgery. Other causes of neuropathy include certain diseases such as diabetes, medications (certain cancer treating drugs), alcohol abuse, and nutritional deficiencies. However, in most cases of painful peripheral neuropathy, the cause is unknown.
Peripheral neuropathy is diagnosed mainly by history and physical examination. Symptoms such as numbness, tingling and pain are commonly present. A physician can perform some simple tests to help confirm the diagnosis. Blood tests for vitamin B-12 levels, thyroid levels, complete blood count (CBC), and a metabolic panel should be done. Sometimes electromyography (EMG) and nerve conduction studies are needed. Most cases of peripheral neuropathy are permanent and there are no options to “cure” the cause of the neuropathy.
Treatment of pain from peripheral neuropathy can be challenging. If there is a correctable cause like a vitamin B-12 deficiency, this can be treated. In most cases, treating the symptoms of pain is all that can be done. Various medications are used to treat the pain. Anticonvulsant medications like gapabentin (Neurontin, Gralise) or pregabalin (Lyrica) are first line treatments. These medications help decrease the activity of pain nerves and often decrease the severity of the pain, but do not eliminate it. Antidepressant medications increase certain chemicals in the brain and spinal cord that help to regulate pain signals, producing pain relief. Opioid (morphine like) medications are minimally effective for nerve pain and are often associated with limiting side effects. Topical medications like capsacin can be effective but may be hard to tolerate. Cannabinoids, one of the active ingredients in THC, have shown some promise, but clinical studies are showing only mild relief and near 100% chance of side effects. Transcutaneous electrical stimulation (TENS) has been shown to be helpful for neuropathy pain in some patients, but the treatment effect is very short lived.
A new therapy called “Scrambler” therapy has shown promise in helping those with severe neuropathic pain from diabetes, chemotherapy, postherpetic neuralgia (such as shingles) and a number of other neuropathies that have not responded to the usual medication treatment. Scrambler therapy uses different types of nerve waveforms similar to ones from our own nerves and delivers them in an unique algorithm to help block pain signals. Initial studies have shown dramatic improvement in symptoms, as much as 90% improvement, that can last for a few months to greater than a year. Most often people are able to reduce or eliminate the medications they are taking for their pain. This is a non-invasive treatment with no known side effects.
Neuropathic pain can be devastating and difficult to treat for many people. Current medication treatments are often minimally helpful or are not well tolerated because of side effects. New therapies are emerging that can deliver very good pain control without those side effects and for a prolonged time. Someone suffering from severe neuropathic pain should discuss these options with their primary care provider.